Say YES to Boundaries in Private Practice. Or Not.

Why should you set boundaries in private practice?

Good boundaries are part of any good relationship. Why should you set boundaries in private practice? In fact, a relationship without boundaries will almost always have other symptoms: violence, emotional arguments, infidelity, addiction, emotional cutoffs, or debilitating enabling. Boundaries can be hard to enforce because the boundary-setter dreads retaliation from the boundary-receiver. Likewise, the boundary-receiver may hold a grudge because, well, no one really LIKES to receive a boundary.

You, dear practice owner, can struggle practicing good boundaries too, but not just because there is a pissed-off boundary receiver. The challenge for you is setting boundaries against the people and THINGS that will crush your dreams and sabotage your success. People like well-intentioned loved ones offering ‘helpful’ advice about how your goals are unrealistic. Things like a drinking habit that isn’t so good for your health, a bed that calls your name seductively when you know there are emails to catch up on, or social media you need to check ‘one more time’ before you get to your to-do list.

Your Are Complicit

In her book “Year of Yes: How to Dance It Out, Stand In the Sun and Be Your Own Person,” Shonda Rhimes, single mother of three girls and creator of award winning TV shows like Grey’s Anatomy, Private Practice, and Scandal, chronicles her journey to a better life. She discovered neglecting boundaries against THINGS like food, her job, and her own introversion actually meant she was saying ‘yes’ to everything from poor health, to social anxiety and workaholism. Her ‘a-ha’ moment? Bad things weren’t just ‘happening’ to her; she was complicit.

In her ‘year of saying yes to everything,’ rather than focusing on boundaries against bad habits, she focused on the positive: say yes to healthy eating and exercise; say yes to the next social engagement and speaking opportunity. When her kids asked, ‘Wanna play?’ she stopped what she was doing and played. When Jimmy Kimmel asked her to appear on his show, she said yes. Not surprisingly her life and her business ‘Shondaland Productions’ improved immensely.

Discovering we have a role in our own self-sabotage can be a pretty unpopular opinion. Uncovering our own agency can feel like too much power and freedom. “It’s not my fault,” you might argue, “I have [insert impossible situation that justifies why you are so exhausted and broke HERE].” If you want to die on that hill stop reading and go tie yourself back up to your burning stake Joan of Ark (was is it stake or a pyre? I’m never sure). If you are ready to say “YES” to a better private practice, read on.

Yes to…

Still with me? Good. Even though we’re mental health providers and we kinda know what boundaries look like in relationships, it is time to learn what they look like in our private practice.

What is a boundary?

Let’s say you love your neighbor, you love your neighbor’s cows, and you love your yard. You do not, however, love your neighbor’s cows IN your yard. In fact, you are starting to lose your serenity and resent your neighbor because of the cows pies on your St. Augustine. Since you value your yard and your serenity, you decide to build a fence. The cows are a little miffed because they can’t get to your grass and your neighbor is a little miffed because his view is now marred by your fence, but you feel amazing because you now have a cow-pie-free yard. Maybe your neighbor will realize happy-yard-happy-neighbor and grow to appreciate your fence, maybe not.

Boundaries are designed to protect YOU the boundary-setter, not the boundary receiver.

You built a fence because you started valuing your peace over your neighbor’s cows’ freedom. There is a possibility the relationship with your neighbor will suffer because of this shift BUT there is also a possibility the relationship will become better than ever based on a new mutual respect.

Boundaries will always require a change in your behavior, not your neighbor’s.

Did the neighbor have a right to graze his cows on your grass? No. Did you have a right to be angry? Yes. Is it fair that you had to spend money and time and energy to build the fence when his cows are the problem?

Yes.

Wait, what?

Yes. If you care more about your serenity (and your yard) than your neighbor does, then take care of it. Spend money, buy the damn fence, and protect it. Don’t expect people to value something you neglect.

How to YES

In business and in private practice we are constantly at war with things that want to steal our most valuable assets: Our time and our money. Make a list of things that deserve your time in order of importance. For example, the first four spots might go to you, your HP (Higher Power), your business, and your family. You protect your business by

Setting boundaries AGAINST:

• People who suck your time, are negative or talk about other people, and ‘lovingly’ crush your dreams.

Saying YES to:

• Keeping dreams to yourself until you feel ready to reveal them to the world.
• Having a few friends you trust to give you an honest reality check and who, in the end, will support your decisions.
• More alone time to contemplate, build your business, and grow yourself.

Setting boundaries AGAINST:

• Habits that don’t grow you. Habits are only fun and funny when they don’t affect your relationships, your money, or your freedom. Throw away your ‘Coffee or die,’ t-shirt. Quit posting funny memes about ‘Wine is a food group.’ Stop going to happy hour.

Saying YES to:

• Tracking how much you spend so you know how much your bad habits are costing you.
• Achieving a healthy number. Go to your doctor and find out your cholesterol, blood sugar, weight, etc. Commit to a healthy number.
• Getting help. If you stay in bed too much/drink too much/eat too much call your doctor or therapist and get some help.

Setting boundaries AGAINST:

• Defining yourself by your diagnosis. Your anxiety is not you. Your cancer is not you.

Saying YES to:

• Something else instead of the diagnosis. Anything else. When I was first diagnosed with breast cancer, I had an excellent reason to quit school. I did not, however, want to quit school. I avoided the pink ribbons and cancer walks and focused on playing tennis again. Mind you, I could never play tennis before cancer. I focused on hitting a tennis ball rather than ‘recovering from cancer.’ I graduated with a Ph.D. in three years instead of four.

How do you not burn out in private practice?

Workload and work setting are the most common factors that lead to burnout in mental health professions. Private practice owners who have made the break from agency work to create their ideal job setting may still burnout if they stay in that ‘agency mindset' of big case loads equal success. Professional boundaries matter. Failing to set professional boundaries to protect your schedule and your availability in the name of getting, or keeping, more clients may compromise YOUR mental health in the end.

Business owners struggle setting boundaries even when we are setting them against the people, concepts, and things that will crush our dreams and sabotage our success. Discovering we have a role in our own self-sabotage and uncovering our own agency can feel like too much power and freedom. Achieve a better business and a better you. Lean in to the discomfort of saying “Yes.”

For more information click here to get The Essential Guide for Self-Employed Mental Health Professionals and Supervisors.

Blog by Kate Walker Ph.D., LPC/LMFT Supervisor in Texas